Provider Demographics
NPI:1316101538
Name:LOW COUNTRY FAMILY SERVICES
Entity type:Organization
Organization Name:LOW COUNTRY FAMILY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILL
Authorized Official - Middle Name:DESHAWN
Authorized Official - Last Name:OUTLAW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-344-4241
Mailing Address - Street 1:PO BOX 912
Mailing Address - Street 2:
Mailing Address - City:VARNVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29944-0912
Mailing Address - Country:US
Mailing Address - Phone:803-943-0159
Mailing Address - Fax:803-943-0612
Practice Address - Street 1:9400 TWO NOTCH RD
Practice Address - Street 2:SUITE F
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29223-5946
Practice Address - Country:US
Practice Address - Phone:803-334-4241
Practice Address - Fax:803-658-0380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-16
Last Update Date:2014-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management